Provider Demographics
NPI:1043232861
Name:ALEXANDER, SCOTT RAYMOND (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:RAYMOND
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 REGENT BLVD
Mailing Address - Street 2:SUITE 155
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-2239
Mailing Address - Country:US
Mailing Address - Phone:972-915-4040
Mailing Address - Fax:972-915-4343
Practice Address - Street 1:3601 REGENT BLVD
Practice Address - Street 2:SUITE 155
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2239
Practice Address - Country:US
Practice Address - Phone:972-915-4040
Practice Address - Fax:972-915-4343
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX223241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice